Is it feasible to use smartphone images to perform telediagnosis of different stages of occlusal caries lesions?
The purpose of this study was to compare the performance of two different models of smartphone and a conventional camera with that of direct clinical examination in detecting caries lesions at different stages of progression in deciduous molars. The photographic equipment consisted of two smartphone...
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description | The purpose of this study was to compare the performance of two different models of smartphone and a conventional camera with that of direct clinical examination in detecting caries lesions at different stages of progression in deciduous molars. The photographic equipment consisted of two smartphones (iPhone and Nexus 4) and a conventional macro camera setup. First, in the laboratory phase of the study, we compared the images of 20 exfoliated primary teeth having caries lesions at different stages. Then, in the clinical phase of the study, the images of 119 primary molars from fifteen children (3 to 6 years old) were used. All of the photographic images were taken using the previously described devices. In both groups, two examiners, blinded to the photographic equipment used, assessed the images independently on a computer screen, and classified them according to the International Caries Detection and Assessment System (ICDAS). The teeth were then examined directly by two other experienced examiners, and the consensus reached was considered the reference standard. Parameters of validity, such as percentage of correct answers, agreement with the reference standard, sensitivity, specificity and inter-examiner agreement (using the weighted kappa test) were calculated. The examiners performed similarly in both in vitro and in vivo studies. Inter-examiner reliability was approximately 0.7 for all the devices in the laboratory setting, and for the macro camera photography system in the clinical setting, but it was approximately 0.9 for the iPhone and Nexus images taken in vivo. With regard to the percentage of correct answers, the highest values were observed for sound and extensive caries lesions in both laboratory and clinical settings. The percentage of correct answers for initial and moderate lesions was particularly low in the clinical evaluation, irrespective of the camera devices used. Therefore, we concluded that photographic diagnosis using smartphone images is feasible and accurate for distinguishing sound tooth surfaces from extensive caries lesions; however, photographic images are not a good method for accurately detecting initial and moderate caries lesions. |
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The photographic equipment consisted of two smartphones (iPhone and Nexus 4) and a conventional macro camera setup. First, in the laboratory phase of the study, we compared the images of 20 exfoliated primary teeth having caries lesions at different stages. Then, in the clinical phase of the study, the images of 119 primary molars from fifteen children (3 to 6 years old) were used. All of the photographic images were taken using the previously described devices. In both groups, two examiners, blinded to the photographic equipment used, assessed the images independently on a computer screen, and classified them according to the International Caries Detection and Assessment System (ICDAS). The teeth were then examined directly by two other experienced examiners, and the consensus reached was considered the reference standard. Parameters of validity, such as percentage of correct answers, agreement with the reference standard, sensitivity, specificity and inter-examiner agreement (using the weighted kappa test) were calculated. The examiners performed similarly in both in vitro and in vivo studies. Inter-examiner reliability was approximately 0.7 for all the devices in the laboratory setting, and for the macro camera photography system in the clinical setting, but it was approximately 0.9 for the iPhone and Nexus images taken in vivo. With regard to the percentage of correct answers, the highest values were observed for sound and extensive caries lesions in both laboratory and clinical settings. The percentage of correct answers for initial and moderate lesions was particularly low in the clinical evaluation, irrespective of the camera devices used. Therefore, we concluded that photographic diagnosis using smartphone images is feasible and accurate for distinguishing sound tooth surfaces from extensive caries lesions; however, photographic images are not a good method for accurately detecting initial and moderate caries lesions.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0202116</identifier><identifier>PMID: 30188900</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Biology and Life Sciences ; Cameras ; Cameras (Photography) ; Child ; Child, Preschool ; Children ; Dental caries ; Dental Caries - diagnosis ; Dental Caries - pathology ; Dentistry ; Diabetic retinopathy ; Diagnosis ; Enamel ; Engineering and Technology ; Female ; Humans ; In vivo methods and tests ; Juvenile offenders ; Lesions ; Male ; Medicine and Health Sciences ; Methods ; Molar - pathology ; Molars ; Patient satisfaction ; Pediatrics ; Photographic equipment ; Photographic equipment & supplies ; Photography ; Photography, Dental - instrumentation ; Photography, Dental - methods ; Risk factors ; Smart phones ; Smartphone ; Smartphones ; Systematic review ; Teeth ; Telemedicine ; Telemedicine - instrumentation ; Telemedicine - methods</subject><ispartof>PloS one, 2018-09, Vol.13 (9), p.e0202116-e0202116</ispartof><rights>COPYRIGHT 2018 Public Library of Science</rights><rights>2018 Kohara et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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Therefore, we concluded that photographic diagnosis using smartphone images is feasible and accurate for distinguishing sound tooth surfaces from extensive caries lesions; however, photographic images are not a good method for accurately detecting initial and moderate caries lesions.</description><subject>Biology and Life Sciences</subject><subject>Cameras</subject><subject>Cameras (Photography)</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Dental caries</subject><subject>Dental Caries - diagnosis</subject><subject>Dental Caries - pathology</subject><subject>Dentistry</subject><subject>Diabetic retinopathy</subject><subject>Diagnosis</subject><subject>Enamel</subject><subject>Engineering and Technology</subject><subject>Female</subject><subject>Humans</subject><subject>In vivo methods and tests</subject><subject>Juvenile offenders</subject><subject>Lesions</subject><subject>Male</subject><subject>Medicine and Health Sciences</subject><subject>Methods</subject><subject>Molar - 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The photographic equipment consisted of two smartphones (iPhone and Nexus 4) and a conventional macro camera setup. First, in the laboratory phase of the study, we compared the images of 20 exfoliated primary teeth having caries lesions at different stages. Then, in the clinical phase of the study, the images of 119 primary molars from fifteen children (3 to 6 years old) were used. All of the photographic images were taken using the previously described devices. In both groups, two examiners, blinded to the photographic equipment used, assessed the images independently on a computer screen, and classified them according to the International Caries Detection and Assessment System (ICDAS). The teeth were then examined directly by two other experienced examiners, and the consensus reached was considered the reference standard. Parameters of validity, such as percentage of correct answers, agreement with the reference standard, sensitivity, specificity and inter-examiner agreement (using the weighted kappa test) were calculated. The examiners performed similarly in both in vitro and in vivo studies. Inter-examiner reliability was approximately 0.7 for all the devices in the laboratory setting, and for the macro camera photography system in the clinical setting, but it was approximately 0.9 for the iPhone and Nexus images taken in vivo. With regard to the percentage of correct answers, the highest values were observed for sound and extensive caries lesions in both laboratory and clinical settings. The percentage of correct answers for initial and moderate lesions was particularly low in the clinical evaluation, irrespective of the camera devices used. Therefore, we concluded that photographic diagnosis using smartphone images is feasible and accurate for distinguishing sound tooth surfaces from extensive caries lesions; however, photographic images are not a good method for accurately detecting initial and moderate caries lesions.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30188900</pmid><doi>10.1371/journal.pone.0202116</doi><tpages>e0202116</tpages><orcidid>https://orcid.org/0000-0002-0693-9014</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Biology and Life Sciences Cameras Cameras (Photography) Child Child, Preschool Children Dental caries Dental Caries - diagnosis Dental Caries - pathology Dentistry Diabetic retinopathy Diagnosis Enamel Engineering and Technology Female Humans In vivo methods and tests Juvenile offenders Lesions Male Medicine and Health Sciences Methods Molar - pathology Molars Patient satisfaction Pediatrics Photographic equipment Photographic equipment & supplies Photography Photography, Dental - instrumentation Photography, Dental - methods Risk factors Smart phones Smartphone Smartphones Systematic review Teeth Telemedicine Telemedicine - instrumentation Telemedicine - methods |
title | Is it feasible to use smartphone images to perform telediagnosis of different stages of occlusal caries lesions? |
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